A new national health funding agreement worth $219.6 billion has been met with strong criticism from the aged care sector, amid concerns it fails to address the growing number of older Australians stranded in public hospitals.
The five year agreement between the Commonwealth and state and territory governments was announced last week and is intended to provide long term funding certainty for public hospitals. However, aged care advocates say the deal overlooks a critical pressure point in the health system, the delayed discharge of older people who are medically ready to leave hospital but have nowhere appropriate to go.
Ageing Australia has warned that the absence of previously discussed funding to tackle hospital discharge delays represents a significant missed opportunity for reform. An additional $2 billion had been flagged to help move older patients out of hospital and into suitable aged care or transitional settings, but this funding was not included in the final agreement.
Ageing Australia chief executive Tom Symondson said the decision sends the wrong message at a time when hospitals are increasingly caring for older patients well beyond their clinical need.
“This was a rare opportunity for state and federal governments to work together to improve outcomes for the thousands of older Australians stuck in hospital for extended periods, but that opportunity has been missed,” Mr Symondson said.
Hospitals across the country are reporting rising numbers of long stay older patients, many of whom are waiting for residential aged care placements, home care packages or specialised services that can meet their complex needs. Sector estimates suggest more than 3,000 people are currently waiting in hospital for access to aged care.
Mr Symondson said the issue is already placing strain on hospitals, families and aged care providers, and will worsen as Australia’s population continues to age.
“The growing number of long stay older people in hospital should have been a clear warning sign for the states and the Commonwealth that only concerted, joint efforts could improve the situation,” he said. “This pressure will only increase and addressing it will require action from all levels of government.”
Australia’s demographic trends are well established. Over the next four decades, the number of people aged over 65 is expected to double, while the population aged over 85 is projected to triple. Without coordinated planning across health and aged care, sector leaders warn the system will struggle to cope.
Ageing Australia has also highlighted a growing mismatch between demand and supply in aged care infrastructure. While demand for places continues to rise, construction of new beds has fallen well short of what is required.
“Demand is growing faster every day. We must invest now,” Mr Symondson said. “And yet last year we built about 800 aged care beds, a drop in the ocean compared to the 10,000 we should be building each and every year just to keep up with demand.”
At the same time, he cautioned against viewing residential beds as a simple solution. Many older people occupying hospital beds have high clinical or behavioural needs that cannot be adequately supported in standard residential care settings.
“But more beds alone will not resolve this issue. Many older people in hospital need higher levels of care and support than a residential home can provide. That is where the states and territories must also play their role,” he said.
Some states have already taken steps to address these gaps. In Western Australia, the state government has committed $100 million to a low interest loan scheme to support providers building beds for older people with lower means. Victoria continues to play a direct role in delivering aged care services for older people with higher levels of clinical need.
Mr Symondson said similar options are available to governments across the country, but require political will and collaboration.
“The Commonwealth, states and territories need to work collaboratively with aged care providers and hospitals to deliver programs that will provide the support people need across the health and aged care systems,” he said. “Every government in Australia can choose to prioritise the needs of older people and they must. Older Australians deserve nothing less.”
For aged care providers, the exclusion of targeted discharge funding raises concerns that hospitals will remain under pressure, while older people continue to experience extended and often inappropriate stays in acute care settings. Sector leaders are calling for renewed focus on integrated planning that recognises aged care as a central part of Australia’s health system, not an afterthought.
